Avista Senior Living Vita Bella, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

AVISTA SENIOR LIVING VITA BELLA, LLC

Practice address

248 N Macdonald
Mesa, AZ 85201-6651

Phone

(480) 964-6685

NPI assigned

Aug 9, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kristopher L Woolley

Title

Managing Member

Phone

(602) 628-5900

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1902185994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 S COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 N MACDONALD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016651",
            "telephone_number": "480-964-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVISTA SENIOR LIVING VITA BELLA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "WOOLLEY",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "602-628-5900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AL8507C",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chakrapani Reddy Avija
• Jacob Avila
• Jovy Avila
• Marie Elizabeth Avila
• Avista Hospice Arizona, LLC
• Aviva Springs LLC
• Avoca Healthcare Group, LLC
• Diana D Awad, PA
• Alexandra Awada, PHARMD
• Awaken the Greatness

• Health Service Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Health Service Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.